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A benign epithelial tumor having a glandular origin and structure
- Acute adrenal crisis is a life-threatening condition that occurs when there is not enough cortisol. This is a hormone produced by the adrenal glands.
- Adrenal crisis occurs when:
- The adrenal gland is damaged due to, for example, Addison disease or other adrenal gland disease, surgery
- The pituitary gland is injured and cannot release ACTH
- Adrenal insufficiency is not properly treated
- Risk factors for adrenal crisis include:
- Infection and other physical stress
- Injury to the adrenal or pituitary gland
- Stopping treatment too suddenly with glucocorticoid medications such as prednisone or hydrocortisone
- Symptoms of adrenal crisis can include any of the following:
- Abdominal pain
- Confusion or coma
- Dizziness or light-headedness
- Flank pain
- High fever
- Loss of appetite
- Loss of consciousness
- Low blood pressure
- Profound weakness
- Rapid heart rate
- Rapid respiratory rate (see tachypnea)
- Slow, sluggish movement
- Unusual and excessive sweating on face or palms
The absence of menstruation in a woman between puberty and menopause. Some causes include pregnancy, decreased body weight, endocrine and other medical disorders, and certain medications.
Loss of appetite, especially as a result of disease.
Of or relating to an immune response by the body against one of its own cells or tissues.
- A symptom complex caused by damage to autonomic nerves.
- Diabetes, alcohol use, traumatic nerve injury, anticholinergics.
- Clinical findings:
- Abdominal bloating, heat intolerance, nausea, vomiting, impotence, diarrhoea, constipation, orthostatic vertigo, dysuria, urinary incontinence.
- 1 insulin-producing cells situated in the islets of Langerhans. Their insulin-producing function tends to accelerate the movement of glucose, amino acids, and fatty acids out of the blood and into the cellular cytoplasm, countering glucagon function of alpha cells.
- 2 the basophilic cells of the anterior lobe of the pituitary gland.
spasm of the hand or foot, or of the thumbs and great toes, seen in tetany.
Obesity defined as increased waist-to-hip and waist-to-thigh ratios, waist circumference and sagittal abdominal diameter, which is accompanied by an increased risk of cardiovascular disease.
- An indication of tetany in which a unilateral spasm of the oris muscle is initiated by a slight tap over the facial nerve anterior to the external auditory canal.
- Seen in hypocalcemia
congenital adrenal hyperplasia
- Congenital adrenal hyperplasia (CAH) is a form of adrenal insufficiency in which the enzyme that produces two important adrenal steroid hormones, cortisol and aldosterone, is deficient. Because cortisol production is impeded, the adrenal gland instead overproduces androgens (male steroid hormones). Females with CAH are born with an enlarged clitoris and normal internal reproductive tract structures. Males have normal genitals at birth. CAH causes abnormal growth for both sexes; patients will be tall as children and short as adults. Females develop male characteristics, and males experience premature sexual development.
- In its most severe form, called salt-wasting CAH, a life-threatening adrenal crisis can occur if the disorder is untreated. Adrenal crisis can cause dehydration, shock, and death within 14 days of birth. There is also a mild form of CAH that occurs later in childhood or young adult life in which patients have partial enzyme deficiency.
- CAH, a genetic disorder, is the most common adrenal gland disorder in infants and children, occurring in one in 10,000 total births worldwide. It affects both females and males. It is also called adrenogenital syndrome.
- Diabetic ketoacidosis (DKA) always results from a severe insulin deficiency. Insulin is the hormone secreted by the body to lower the blood sugar levels when they become too high. Diabetes mellitus is the disease resulting from the inability of the body to produce or respond properly to insulin, required by the body to convert glucose to energy. In childhood diabetes, DKA complications represent the leading cause of death, mostly due to the accumulation of abnormally large amounts of fluid in the brain (cerebral edema). DKA combines three major features: hyperglycemia, meaning excessively high blood sugar kevels; hyperketonemia, meaning an overproduction of ketones by the body; and acidosis, meaning that the blood has become too acidic.
- Insulin deficiency is responsible for all three conditions: the body glucose goes largely unused since most cells are unable to transport glucose into the cell without the presence of insulin; this condition makes the body use stored fat as an alternative source instead of the unavailable glucose for energy, a process that produces acidic ketones, which build up because they require insulin to be broken down. The presence of excess ketones in the bloodstream in turn causes the blood to become more acidic than the body tissues, which creates a toxic condition.
the nephropathy seen in later stages of diabetes mellitus, with first hyperfiltration, renal hypertrophy, microalbuminuria, and hypertension, and later proteinuria and end-stage renal disease.
Diabetic neuropathy is a nerve disorder caused by diabetes mellitus. Diabetic neuropathy may be diffuse, affecting several parts of the body, or focal, affecting a specific nerve and part of the body.
the secretion of sweat, especially the profuse secretion associated with an elevated body temperature, physical exertion, exposure to heat, and mental or emotional stress. Sweating is centrally controlled by the sympathetic nervous system and is primarily a thermoregulatory mechanism. However, the sweat glands on the palms and soles respond to emotional stimuli and do not always participate in thermal sweating. The rate of sweating is generally not affected by water deficiency, but it may be reduced by severe dehydration; it also diminishes when salt intake exceeds salt loss.
- When there is an increase in the volume of the tissue behind the eyes, the eyes will appear to bulge out of the face. The terms exophthalmos and proptosis apply. Proptosis can refer to any organ that is displaced forward, while exophthalmos refers just to the eyes.
- The most common cause of exophthalmos is Graves' disease, overactivity of the thyroid gland. The contents of the orbits swell due to inflammation, forcing the eyes forward. The inflammation affects primarily the muscles. This combination of muscle impairment and forward displacement reduces eye movement, causing double vision and crossed eyes (strabismus). The optic nerves can also be affected, reducing vision, and the clear membrane (conjunctiva) covering the white part of the eyes and lining the inside of the eyelids can swell. Finally, the eyes may protrude so far that the eyelids cannot close over them, leading to corneal damage.
- Exophthalmos from Graves' disease is bilateral (occurring on both sides), but not necessarily symmetrical. In contrast, exophthalmos from orbital tumors or a blood clot in the brain happens on only one side.
- Galactorrhea is the secretion of breast milk in men, or in women who are not breastfeeding an infant.
- Galactorrhea is associated with a number of conditions. The normal production of breast milk is controlled by a hormone called prolactin, which is secreted by the pituitary gland in the brain. Any condition that upsets the balance of hormones in the blood or the production of hormones by the pituitary gland or sexual organs can stimulate the production of prolactin.
- Often, a patient with galactorrhea will have a high level of prolactin in the blood. A tumor in the pituitary gland can cause this overproduction of prolactin. At least 30% of women with galactorrhea, menstrual abnormalities, and high prolactin levels have a pituitary gland tumor. Other types of brain tumors, head injuries, or encephalitis (an infection of the brain) can also cause galactorrhea.
Nerve damage of the stomach that delays or stops stomach emptying, resulting in nausea, vomiting, bloating, discomfort, and weight loss.
The capacity of a drug, chemical, or other exposure to produce injury to the liver. Agents with recognized hepatotoxicity include carbon tetrachloride, alcohol, dantrolene sodium, valproic acid, and isonicotinic acid hydrazide.
- Excessive growth of facial or body hair in women is called hirsutism.
- The condition usually develops during puberty and becomes more pronounced as the years go by. However, an inherited tendency, over-production of male hormones (androgens), medication, or disease, can cause it to appear at any age.
- Women who have hirsutism usually have irregular menstrual cycles. They sometimes have small breasts and deep voices, and their muscles and genitals may become larger than women without the condition.
A focal increase in radioisotope uptake on a 123I scintillation scan in a solid organ—e.g., liver or thyroid—seen by immunoscintigraphy. Thyroid hot nodules often correspond to toxic nodular or multinodular goiter, as functional thyroid lesions suppress TSH synthesis; they are rarely malignant
A focus of decreased radioisotope uptake on a 123I or 99mTc scintillation scan of the thyroid, seen in cystic or solid, often nonfunctional lesions; when the mass is solid by ultrasound, a biopsy is warranted as 15% of cold nodules are carcinomas.
- Hypercalcemia is an abnormally high level of calcium in the blood, usually more than 10.5 milligrams per deciliter of blood.
- Many different conditions can cause hypercalcemia; the most common are hyperparathyroidism and cancer.
- PRIMARY HYPERPARATHYROIDISM. Primary hyperparathyroidism is the excessive secretion of parathyroid hormone by one or more of the parathyroid glands. It is the most common cause of hypercalcemia in the general population. Women have this condition more frequently than men do, and it is more common in older people. It can appear thirty or more years after radiation treatments to the neck. Ninety percent of the cases of primary hyperparathyroidism are caused by a non-malignant growth on the gland.
- Hyperparathyroidism can also occur as part of a rare hereditary disease called multiple endocrine neoplasia. In this disease, tumors develop on the parathyroid gland.
- CANCER. People with cancer often have hypercalcemia. In fact, it is the most common life-threatening metabolic disorder associated with cancer. Ten to twenty percent of all persons with cancer have hypercalcemia. Cancers of the breast, lung, head and neck, and kidney are frequently associated with hypercalcemia. It also occurs frequently in association with certain cancers of the blood, particularly malignant myeloma. It is seen most often in patients with tumors of the lung (25-35%) and breast (20-40%), according to the National Cancer Institute. Cancer causes hypercalcemia in two ways. When a tumor grows into the bone, it destroys bony tissue (osteolysis). When the bone is not involved, factors secreted by cancer cells can increase calcium levels (humoral hypercalcemia of malignancy). The two mechanisms may operate at the same time.
- Because immobility causes an increase in the loss of calcium from bone, cancer patients who are weak and spend most of their time in bed are more prone to hypercalcemia. Cancer patients are often dehydrated because they take in inadequate amounts of food and fluids and often suffer from nausea and vomiting. Dehydration reduces the ability of the kidneys to remove excess calcium from the body. Hormones and diuretics that increase the amount of fluid released by the body can also trigger hypercalcemia.
- OTHER CAUSES. Other conditions can cause hypercalcemia. Excessive intake of vitamin D increases intestinal absorption of calcium. During therapy for peptic ulcers, abnormally high amounts of calcium antacids are sometimes taken. Over use of antacids can cause milk-alkali syndrome and hypercalcemia. Diseases such as Paget's, in which bone is destroyed or reabsorbed, can also cause hypercalcemia. As in cancer or paralysis of the arms and legs, any condition in which the patient is immobilized for long periods of time can lead to hypercalcemia due to bone loss.
- Many patients with mild hypercalcemia have no symptoms and the condition is discovered during routine laboratory screening. Gastrointestinal symptoms include loss of appetite, nausea, vomiting, constipation, and abdominal pain. There may be a blockage in the bowel. If the kidneys are involved, the individual will have to urinate frequently during both the day and night and will be very thirsty. As the calcium levels rise, the symptoms become more serious. Stones may form in the kidneys and waste products can build up. Blood pressure rises. The heart rhythm may change. Muscles become increasingly weak. The individual may experience mood swings, confusion, psychosis, and eventually, coma and death.
- Hypocalcemia, a low bood calcium level, occurs when the concentration of free calcium ions in the blood falls below 4.0 mg/dL (dL = one tenth of a liter). The normal concentration of free calcium ions in the blood serum is 4.0-6.0 mg/dL.
- Hypocalcemia can be caused by hypoparathyroidism, by failure to produce 1,25-dihydroxyvitamin D, by low levels of plasma magnesium, or by failure to get adequate amounts of calcium or vitamin D in the diet. Hypoparathyroidism involves the failure of the parathyroid gland to make parathyroid hormone. Parathyroid hormone controls and maintains plasma calcium levels. The hormone exerts its effect on the kidneys, where it triggers the synthesis of 1,25-dihydroxyvitamin D. Thus, hypocalcemia can be independently caused by damage to the parathyroid gland or to the kidneys. 1,25-Dihydroxyvitamin D stimulates the uptake of calcium from the diet and the mobilization of calcium from the bone. Bone mobilization means the natural process by which the body dissolves part of the bone in the skeleton in order to maintain or raise the levels of plasma calcium ions.
- Low plasma magnesium levels (hypomagnesia) can result in hypocalcemia. Hypomagnesemia can occur with alcoholism or with diseases characterized by an inability to properly absorb fat. Magnesium is required for parathyroid hormone to play its part in maintaining plasma calcium levels. For this reason, any disease that results in lowered plasma magnesium levels may also cause hypocalcemia.
- Hypocalcimia may also result from the consumption of toxic levels of phosphate. Phosphate is a constituent of certain enema formulas. An enema is a solution that is used to cleanse the intestines via a hose inserted into the rectum. Cases of hypocalcemia have been documented where people swallowed enema formulas, or where an enema has been administered to an infant.
- Symptoms of severe hypocalcemia include numbness or tingling around the mouth or in the feet and hands, as well as in muscle spasms in the face, feet, and hands. Hypocalcemia can also result in depression, memory loss, or hallucinations. Severe hypocalcemia occurs when serum free calcium is under 3 mg/dL. Chronic and moderate hypocalcemia can result in cataracts (damage to the eyes). In this case, the term "chronic" means lasting one year or longer.
- Pseudodiarrhea, formerly known as hyperdefecation, is defined as increased stool frequency (more than three times daily) with a normal daily stool weight of less than 300 g.
- Pseudodiarrhea is often associated with rectal urgency and accompanies irritable bowel syndrome, hyperthyroidism, and anorectal disorders such as proctitis. Patients with rectal obstruction (e.g., from fecal impaction, obstruction due to a vaginal pessary) may also present with pseudodiarrhea, since only liquid stool can make it through.
- Pseudodiarrhea may be more common than chronic diarrhea and should always be considered in patients complaining of chronic diarrhea.
- An excessive amount of prolactin in the blood, usually caused by a pituitary adenoma but sometimes caused by endocrine side effects related to certain antipsychotic medications. In women it is usually associated with galactorrhea and secondary amenorrhea; in men it may be a factor in gynecomastia, decreased libido, and impotence.
- The presence of abnormally high levels of prolactin in the blood. Normal levels are less than 500 mIU/L [20 ng/mL or ug/L] for women, and less than 450 mIU/L for men.
- Prolactin is a peptide hormone produced by the anterior pituitary gland primarily associated with lactation and plays a vital role in breast development during pregnancy. Hyperprolactinaemia may cause galactorrhea(production and spontaneous flow of breast milk) and disruptions in the normal menstrual period in women and hypogonadism, infertility and erectile dysfunction in men.
- Hyperprolactinaemia can be a part of normal body changes during pregnancy and breastfeeding. It can also be caused by diseases affecting the hypothalamus and pituitary gland. It can also be caused by disruption of the normal regulation of prolactin levels by drugs, medicinal herbs and heavy metals. Hyperprolactinaemia may also be the result of disease of other organs such as the liver, kidneys, ovaries and thyroid.
An exaggerated response of the deep tendon reflexes, usually resulting from injury to the central nervous system or metabolic disease. (hypomagnesemia)
The condition called hypoglycemia is literally translated as low blood sugar. Hypoglycemia occurs when blood sugar (or blood glucose) concentrations fall below a level necessary to properly support the body's need for energy and stability throughout its cells.
- Insulin resistance is not a disease as such but rather a state or condition in which a person's body tissues have a lowered level of response to insulin, a hormone secreted by the pancreas that helps to regulate the level of glucose (sugar) in the body. As a result, the person's body produces larger quantities of insulin to maintain normal levels of glucose in the blood. There is considerable individual variation in sensitivity to insulin within the general population, with the most insulin-sensitive persons being as much as six times as sensitive to the hormone as those identified as most resistant. Some doctors use an arbitrary number, defining insulin resistance as a need for 200 or more units of insulin per day to control blood sugar levels. Various researchers have estimated that 3-16 percent of the general population in the United States and Canada is insulin-resistant; another figure that is sometimes given is 70-80 million Americans.
- Insulin resistance can be thought of as a set of metabolic dysfunctions associated with or contributing to a range of serious health problems. These disorders include type 2 diabetes (formerly called adult-onset or non-insulin-dependent diabetes), the metabolic syndrome (formerly known as syndrome X), obesity, and polycystic ovary syndrome. Some doctors prefer the term "insulin resistance syndrome" to "metabolic syndrome."
A abnormal respiratory pattern characteized by rapid, deep breathing, often seen in patients with metabolic acidosis. Sign of DKA
- Enlargement of the tongue due to accumulation of various substances, oedema, ectopic tissue, tumours, etc.
- Amyloidosis, Beckwith-Wiedemann syndrome, congenital hypo-thyroidism, cystic hygroma, Down syndrome, ectopic thyroid, glycogen storage disease type II (Pompe’s disease), hemangioma (of tongue), Hurler syndrome, intestinal duplication, lymphangioma, mannosidosis, neurofibromatosis, rhabdomyoma, Sandhoff’s disease.
a prolactin-secreting pituitary tumor more than 10 mm in diameter that causes serum prolactin levels higher than 500 ng/mL.
- pathological changes in arterioles and capillaries causing relative ischaemia of skin, renal and retinal tissues, the vasa nervosum and vasa vasorum; characteristic of diabetes mellitus
- diabetic microangiopathy - Microvascular disease Any clinical or pathological changes resulting from small vessel disease in PTs with DM Measurement Capillary HTN can be measured directly by microcannulation of nailfold capillaries with a glass micropipette Prognosis Progression can be slowed by tight control of serum glucose levels, especially with long-term intense insulin therapy
- maturity onset diabetes of the young
- Any of a number of dominantly inherited, monogenic defects of insulin secretion occurring at any age (most commonly types 2 and 3). MODYs do not include any forms of type-2 diabetes, and comprise 1–2% of those initially diagnosed with diabetes. Given that MODYs are autosomal dominant, those with the faulty gene have a 95% chance of developing MODY during their lifetimes. Diagnosing MODY is important as some forms do not need insulin and may do well with oral hypoglycaemic agents, and because other family members can be identified and their treatment modified if appropriate.
roundness of the face due to increased fat deposition laterally seen in patients with hyperadrenocorticalism, either of endogenous (for example, Cushing disease) or exogenous origin (for example, use of cortisonelike drugs during therapy).
an often fatal complication of long-term hypothyroidism in which the patient is comatose with hypothermia, depression of respiration, bradycardia, and hypotension; usually seen in elderly patients during cold weather.
The formation of new blood vessels–ie, capillary ingrowth and endothelial proliferation in unusual sites, a finding typical of so-called 'angiogenic diseases,' which include angiogenesis in tumor growth, diabetic retinopathy, hemangiomas, arthritis, psoriasis
- True oligomenorrhea can not occur until menstrual periods have been established. In the United States, 97.5% of women have begun normal menstrual cycles by age 16. The complete absence of menstruation, whether menstrual periods never start or whether they stop after having been established, is called amenorrhea. Oligomenorrhea can become amenorrhea if menstruation stops for six months or more.
- Women with polycystic ovary syndrome (PCOS) are also likely to suffer from oligomenorrhea. PCOS is a condition in which the ovaries become filled with small cysts. Women with PCOS show menstrual irregularities that range from oligomenorrhea and amenorrhea on the one hand to very heavy, irregular periods on the other. The condition affects about 6% of premenopausal women and is related to excess androgen production.
- Other physical and emotional factors also cause a woman to miss periods. These include:
- emotional stress
- chronic illness
- poor nutrition
- eating disorders such as anorexia nervosa
- excessive exercise
- estrogen-secreting tumors
- illicit use of anabolic steriod drugs to enhance athletic performance
- Symptoms of oligomenorrhea include:
- menstrual periods at intervals of more than 35 days
- irregular menstrual periods with unpredictable flow
- some women with oligomenorrhea may have difficulty conceiving.
Any eye disease. External ophthalmopathy refers to any disease of the conjunctiva, cornea, eyelids or the appendages of the eye. Internal ophthalmopathy refers to any disease of the lens, retina or other internal structures of the eye.
A bone disease characterized by bone demineralization due to deficiency or impaired metabolism of vitamin D or phosphates. Also called adult rickets, late rickets.
Reduction in bone mass, usually caused by a lowered rate of formation of new bone that is insufficient to keep up with the rate of bone destruction. Osteopenia often occurs together with amenorrhea and eating disorders in female athletes. It can lead to premature osteoporosis if left untreated.
The word osteoporosis literally means "porous bones." It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium. Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis.
A prickly, tingling sensation.
- A sharp spasm or fit; a convulsion.
- A sudden onset of a symptom or disease, especially one with recurrent manifestations, such as the chills and fever of malaria
an edema of the eyelids in association with local injury, allergic reactions, hypoproteinemia, trichinosis, and myxedema.
excessive ingestion of food. Polyphagia may be a sign of metabolic disease in which the nutritional requirements of the subject are greater than normal. eg: diabetes mellitus, hyperthyroidism, cushing's syndrome.
the excretion of an abnormally large quantity of urine. Some causes of polyuria are diabetes insipidus, diabetes mellitus, use of diuretics, excessive fluid intake, and hypercalcemia.
excessive thirst. It is characteristic of several different conditions, including diabetes mellitus, in which an excessive concentration of glucose in the blood osmotically pulls intracellular fluid into the bloodstream and increases the excretion of fluid via increased urination, which leads to hypovolemia and thirst. In diabetes insipidus the deficiency of the pituitary antidiuretic hormone results in excretion of copious amounts of dilute urine, reduced fluid volume in the body, and polydipsia. In nephrogenic diabetes insipidus there is also copious excretion of urine with consequent polydipsia. Polyuria resulting from other forms of renal dysfunction also leads to polydipsia. The condition also may be psychogenic in origin.
localized edema associated with preceding hyperthyroidism and exophthalmos, occurring typically on the anterior (pretibial) surface of the legs, the mucin deposits appearing as both plaques and papules.
with reference to food, the converse of hunger - the sensation of satisfaction or fullness. Mediated by the hypothalamus and influenced by many complex factors, including hormone secretions from the gut in response to a full meal, vagal afferent stimulation by stomach distension, insulin/glucagon secretion and blood glucose concentration.
- A state of drowsiness; sleepiness.
- A condition of semiconsciousness approaching coma.
a streak or a linear scar that often results from rapidly developing tension in the skin, such as seen on the abdomen after pregnancy. Purplish striae are among the classic findings in hyperadrenocorticism. Also called stretch mark.
angina pectoris or angina-like chest pain associated with normal arteriographic appearance of the coronary arteries.
a crisis of uncontrolled thyrotoxicosis caused by the release into the bloodstream of increased amounts of thyroid hormone. Thyroid storm may occur spontaneously or be precipitated by infection, stress, or a thyroidectomy performed on a patient who is inadequately prepared with antithyroid drugs. Characteristic signs are fever that may reach 106° F, a rapid pulse, acute respiratory distress, apprehension, restlessness, irritability, and prostration. The patient may become delirious, lapse into a coma, and die of heart failure. Also called thyroid crisis.
- inflammation of the thyroid gland
- The thyroid is the largest gland in the neck. It produces, secretes, and stores thyroxine (T4), a hormone that influences the metabolism of just about every body process.
- When the thyroid gland is functioning properly, hormone release is carefully regulated. When bacteria or viruses invade and inflame the gland, T4 surges into the bloodstream and raises hormone levels that then discourage the gland from creating more T4. Eventually the hormone stores are exhausted, the thyroid loses its ability to manufacture T4, and an underactive thyroid (hypothyroidism) results.
- The major cause of hypothyroidism, thyroiditis affects about 12 million people in the United States. This condition is more common in women than in men and usually develops between ages 30-50.
- Hashimoto's disease:
- The most common type of thyroiditis is Hashimoto's disease, a painless disorder also known as:
- autoimmune thyroiditis
- chronic lymphocytic thyroiditis
- lymphadenoid goiter
- Struma lymphomatosa
- Hashimoto's disease can develop at any age, but is most common in middle-aged women. This immune system disorder runs in families, and affects about 5% of adults in the United States.
- Hashimoto's disease slowly destroys thyroid tissue and robs the gland of its ability to change iodine into T4. The condition progresses so gradually that many people who have it do not realize anything is wrong until the enlarged gland forms a goiter, a swelling seen and felt in the front of the neck. This may not happen until weeks or even years after an individual develops Hashimoto's.
Trousseau's sign / phenomenon
a test for latent tetany in which carpal spasm is induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes. A positive test may be seen in hypocalcemia and hypomagnesemia.
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